Goodacre B W, Chipperfield P, Harrison P B
Department of Radiology, University of British Columbia, Vancouver.
Can Assoc Radiol J. 1990 Oct;41(5):308-10.
Hemobilia is a frequent complication of percutaneous transhepatic biliary drainage, occurring most commonly at the time of initial catheter placement. The authors report on the angiographic diagnosis and embolization of a pseudoaneurysm of the right hepatic artery in a patient with hemobilia. This occurred after 2.5 years of catheter drainage for biliary obstruction due to malignant disease. Bleeding as a complication of biliary drainage can be the result of inadvertent placement of catheter side holes in the hepatic parenchyma, iatrogenic arterioportal and arteriohepatic venous shunts and pseudoaneurysms. This case report illustrates that hemobilia, even with long-term percutaneous transhepatic biliary drainage, may be associated with a radiologically treatable, drainage-related vascular abnormality rather than simply diffuse hemorrhage from a friable tumor.
胆道出血是经皮经肝胆道引流的常见并发症，最常发生在初次放置导管时。作者报告了一例胆道出血患者右肝动脉假性动脉瘤的血管造影诊断及栓塞情况。这发生在因恶性疾病导致胆道梗阻进行导管引流2.5年后。胆道引流的并发症出血可能是由于导管侧孔意外置于肝实质内、医源性动门脉和动肝静脉分流以及假性动脉瘤所致。本病例报告表明，即使是长期经皮经肝胆道引流，胆道出血也可能与一种可通过放射学治疗的、与引流相关的血管异常有关，而不仅仅是来自易碎肿瘤的弥漫性出血。
